Senate Finance Committee rejects Medicaid expansion

CONCORD – The Senate Finance Committee Wednesday night voted 4-2 to reject Medicaid expansion under the Affordable Care Act and instead establish a commission to study the potential impact on the state.

Senate President Peter Bragdon, R-Milford, said he has reservations about the federal government meeting its obligation to pay 100 percent of the cost of the program for the first three years and then gradually reducing its share to 90 percent after seven years.

Medicaid expansion would cover about 60,000 Granite Staters who are currently uninsured and while paying state health care providers about $2.5 billion for medical services over the next seven years.

"The federal government is making many promises when it comes to helping states fund Medicaid expansion, but we have been disappointed before with these types of promises and need to be cautious," Bragdon said. "Furthermore, neither the information we have received from HHS (Health and Human Services) nor other studies, are able to point to clear evidence to prove expanding Medicaid will lead to lower costs or improved health care outcomes."

Instead he proposed establishing a bi-partisan commission to answer the questions and issue a final report by Dec. 1, 2014. The commission would have $200,000 to do its work.

Senate Finance Committee member Sen. Lou D'Allesandro, D-Manchester, argued against Bragdon's proposals saying Medicaid expansion, moving to managed care system and fixing the Medicaid Enhancement Tax – a tax on hospitals net patient receipts – are key to balancing the state budget over the next two years.

Last week state health and human services officials urged the Finance Committee to include expansion in its budget, saying it could possibly not cost the state anything over the first few years and bring $2.5 billion into the state, while providing health insurance for approximately 58,000 residents.

They said the cost to the state could be about $27 million over seven years.

The Senate Finance Committee hopes to take a final vote on its proposed budget Tuesday and then the Senate would vote June 6.

The House included Medicaid expansion in its proposed budget, and expansion is backed by Gov. Maggie Hassan.House and Senate budget negotiators are expected to address the issue as they try to reach a compromise on the next biennium's budget which is to go into effect July 1.